Randomized trial of adjuvant tamoxifen combined with postoperative radiation therapy or adjuvant chemotherapy in postmenopausal breast cancer

Article Abstract:

Many studies have shown that postoperative therapy is an important aspect of improving the survival of breast cancer patients. Radiation is an effective and popular postoperative therapy, but it is uncertain which therapy provides the best chance of survival for the patient. In an effort to more fully evaluate postoperative therapy, radiotherapy and chemotherapy were compared in 427 postmenopausal women who had undergone modified radical mastectomy for breast cancer. In addition, the potential benefits of anti-estrogen therapy were evaluated using the drug tamoxifen, which the patients received daily for two years after surgery. There were, therefore, four experimental groups; radiotherapy and chemotherapy, with and without tamoxifen. At 10 years, the recurrence-free survival for radiotherapy was better than that for chemotherapy. In addition, the addition of tamoxifen improved survival regardless of whether the patient received radiotherapy or chemotherapy. The best results for the patients in this study were thus obtained with the combination of radiotherapy and tamoxifen. The recurrence-free survival at 10 years was 63 and 57 percent for radiotherapy with and without tamoxifen, respectively. For chemotherapy, the rates were 47 and 31 percent with and without tamoxifen. The results for overall survival showed the same trend, although statistical significance was not achieved; the survival rates were 65, 62, 52, and 50 percent for radiotherapy with and without tamoxifen and for chemotherapy with and without tamoxifen, respectively. These findings clearly demonstrate that postoperative therapy plays an important role in the management of the breast cancer patient and in improving her survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Radiotherapy, Chemotherapy, Tamoxifen, Estrogen antagonists

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Predictive value of tumor estrogen and progesterone receptor levels in postmenopausal women with advanced breast cancer treated with toremifene

Article Abstract:

Toremifene is a triphenylethylene compound similar to tamoxifen. Like tamoxifen, toremifene is an antiestrogen agent that binds tightly to estrogen receptors on cells. Although antiestrogen drugs do not kill breast cancer cells, they can arrest their continued growth in some patients, and thus antiestrogens serve as a useful adjunct to other forms of chemotherapy. There is a relationship between the presence of estrogen receptors on breast cancer cells and the responsiveness of the cancer to antiestrogen treatment. However, not all estrogen-positive cancers respond, nor do all estrogen negative cancers fail to respond. To determine characteristics of breast cancers that might influence the likelihood of response to toremifene, researchers studied 113 postmenopausal patients with advanced breast cancer. While all these patients were positive for the estrogen receptor, they had different concentrations of receptors on the surface of their cancer cells. The researchers compared women with a concentration of estrogen receptor of less than 50 femtomole of receptor per milligram of total protein with women with concentrations greater than 50. (A femtomole is one quadrillionth of a mole and represents roughly 600 million receptor molecules.) The results indicated there was no difference in the response rate between the two groups, nor did the concentration of the progesterone receptor influence the response rate. However, among the patients who responded, those with higher concentrations of estrogen receptor enjoyed a longer duration of remission prior to relapse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Prognosis, Hormone receptors, Postmenopausal women, Progesterone, Estrogen receptors, Progesterone receptors, Tormifene (Medication)

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